Karin Smyth MP: speeches

Speeches

• 11 Feb 2026 · Hughes Report: Second Anniversary · Hansard source

  More

  I will, but I do want to respond to Members’ comments.

• 11 Feb 2026 · Hughes Report: Second Anniversary · Hansard source

  More

  I will give way first to the hon. Member for Aberdeenshire North and Moray East.

• 11 Feb 2026 · Hughes Report: Second Anniversary · Hansard source

  More

  I am happy to answer that at the end of my comments, but first I will take the intervention from the right hon. Member for New Forest East.

• 11 Feb 2026 · Hughes Report: Second Anniversary · Hansard source

  More

  It is a pleasure to serve under you chairship, Dr Allin-Khan. I am grateful for the opportunity to address the House following the second anniversary of the report by the Patient Safety Commissioner, Dr Henrietta Hughes. I pay tribute to her work and, as others have, to Baroness Cumberlege for her work in the lead-up to that report. I also thank the hon. Member for Chesham and Amersham (Sarah Green) for securing this important debate. It has been a thoughtful and constructive debate on an issue that is highly sensitive for Members across the House, for campaigners and people who are here today, and for people watching online. To answer the question from the hon. Member for Sleaford and North Hykeham (Dr Johnson), I am responding to this debate on behalf of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Glasgow South West (Dr Ahmed). He is the lead Minister for this area, but unfortunately cannot be here today—as Members will understand, that is often an issue, but I am happy to stand in. This is a matter of great interest to him personally. As colleagues know, he is a clinician, so has valuable insight into patient safety and how it works from a clinical perspective. My hon. Friend wanted me to be clear that he is very happy to meet campaigners, as the hon. Member for Chesham and Amersham asked, to discuss our work in more detail. He met the Patient Safety Commissioner in December to discuss the Department’s ongoing work in relation to her report. Since then, he has continued his engagement with the commissioner on how we can do more to address the immediate needs of those affected by sodium valproate and pelvic mesh. As we have heard, and as many of us know from constituents—I know that many other Members have affected constituents but were not able to attend the debate—some of these women’s lives, as well as those of their families, have been changed forever because they were misled about the effects of sodium valproate and surgical mesh. Many examples have been given in the debate, and constituents of mine have shared the most intimate details of the impact of sodium valproate and pelvic mesh. It has been truly harrowing for me and many other Members to listen to those details, as I am sure it was for those women who bravely shared them with a stranger, their Member of Parliament. That point was made well by many Members, including my hon. Friend the Member for Rushcliffe (James Naish), the hon. Member for Frome and East Somerset (Anna Sabine), and the Liberal Democrat spokesperson, the hon. Member for South Devon (Caroline Voaden), who spoke on behalf of her constituents. We owe honesty, transparency and contrition to all the women affected, and we are determined to make sure that the lessons are learned and to keep patient safety at the heart of the reform. My hon. Friend the Member for Wolverhampton West (Warinder Juss) rightly highlighted the issue of trust in the system, which is so important as we go forwards. Our focus remains on building a system that listens and that acts with speed, compassion and proportionality. Everybody who has suffered complications from sodium valproate and pelvic mesh implants has my deepest sympathies. I express my gratitude to Dr Hughes and her team for the report that was published two years ago, and I am grateful, too, for her continued engagement with the Department as Patient Safety Commissioner.

• 11 Feb 2026 · Hughes Report: Second Anniversary · Hansard source

  More

  I will continue, if I may. On non-financial redress, the Department is committed to meeting the needs of current patients with clinical requirements via three principal avenues. The first is improving clinical services and treatment to patients, and the second is commissioning further research and development programmes on sodium valproate and pelvic mesh to address the remaining knowledge gaps. I commend my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) for sharing again his personal experiences and for laying bare the deep complexity and the need for more research and development, to which my hon. Friend the Under-Secretary of State is committed. The hon. Member for Leicester South (Shockat Adam), with his clinical knowledge, also added useful experience to the debate. That is absolutely what my hon. Friend will be taking forward. The third avenue is initiating longer-term preventive measures that will help ensure that the system can pick up on adverse trends in patient care and act more quickly in the future. I will take each avenue in turn. On improvement of clinical services, although the number of women up to the age of 54 who have been prescribed sodium valproate has nearly halved since 2018, there is a significant group of patients already affected who have complex and varied needs, and the health system has to ensure that that cohort receives high-quality and tailored care. NHS England has committed to a pilot project on foetal exposure to medicine in the north of England, involving multiple clinical specialties and a wide range of clinical experts, that will undertake a comprehensive review of the service. Eighty patients have been seen as part of the pilot, representing 560 appointments and 650 clinical hours. We have received feedback from patients on the value for their quality of life of being seen by clinical experts and wider multidisciplinary teams. We are considering options to commission this service further nationwide. NHS England has also completed an internal review of mesh centres across England. Mesh centres undoubtedly offer a valuable and impactful service, with nearly 3,000 patients now seen since their introduction. However, as a relatively new service, distinct areas for improvement remain, and we will look closely at the results of the internal review and promptly deliver the necessary improvements. With regard to further research and development, the National Institute for Health and Care Research has been commissioned for a £1.56 million study to develop patient-reported outcome measures for prolapse, incontinence and mesh-complication surgery. In the longer term, those measures will be integrated into the pelvic floor registry, which monitors and improves the safety of mesh patients. Further research is also taking place in this area, and we will ensure that future work takes into account the recommendations of the pilot project and of the mesh centre audit. On longer-term prevention work, recent discussions with NHS England and the Medicines and Healthcare products Regulatory Agency indicate that longer-term improvements in digitisation will help position the UK as a world leader in reducing valproate-exposed births and applying the insights to other teratogenic medicines. The Department will explore increasing centralisation and visibility of the annual risk acknowledgment form across care settings, as highlighted in the Hughes report, and may consider expanding the medicines and pregnancy registry to better link data with research outcomes.

• 11 Feb 2026 · Rural GPs: Funding · Hansard source

  More

  It is a pleasure to serve under your chairship, Ms Lewell. I thank the right hon. Member for Tatton (Esther McVey) for securing the debate and raising a critical issue that I know is important to many hon. Members. I am pleased to be here on behalf of the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), who is working hard on the issue. This Government have made primary care a pillar of NHS reform, to make the left shift and put more healthcare into the community. In our 10-year plan, we specifically highlighted our commitment to people in rural and coastal areas, because they have been left behind. As the hon. Member for Chester South and Eddisbury (Aphra Brandreth) highlighted, the infrastructure is appalling in many places, and some of those areas have the worst deprivation in the country. Last week, I was pleased to visit Redruth in Cornwall and talk to a GP practice about the deprivation it faces and the work it is doing. We do understand that, which is why we highlighted it in our 10-year plan. Over the last 18 months, we have taken a number of measures to increase funding, support our workforce and improve patient access, so that we can rebuild the front door to the NHS and create a neighbourhood health service. It is important to remember that when we came into office 18 months ago, we found GP services in an appalling state: underfunded, understaffed and in crisis. First, we inherited an absurd state of affairs where patients could not book appointments, while GPs could not find work. We took immediate action to put GPs to work so that patients could get the care they need. We promised to recruit 1,000 more GPs through the additional roles reimbursement scheme, and we recruited not 1,000 or 2,000, but 3,000. In the right hon. Lady’s ICB area of Cheshire and Merseyside, there were 102 more GPs on the frontline at the end of last year compared with when we took office. Secondly, for the first time in more than a decade, we have agreed a GP contract, which means more than £1 billion extra for general practices, bringing total spend on the contract to £13.4 billion this financial year. That is the biggest cash increase in more than a decade. Thirdly, the previous Government left GP surgeries across the country with leaky pipes, falling roofs and buckets catching rainwater. We are investing £102 million to fix GP surgeries this year, and over the next four years, we are committed to investing another £426 million on GP estates and refurbishing neighbourhood health centres. On top of that, ICBs will have £195 million every year to support strategic primary care investments, with a focus on replacing crumbling infrastructure —an issue that many Members have raised today. I am proud to say we can now see some green shoots of recovery in primary care. According to the Office for National Statistics, patient satisfaction has gone from 60% to 73% since this Government took office. A lot has been done, but we absolutely recognise that there is a lot more to do, especially as GPs become the cornerstone of our neighbourhood health services. Over the course of this Parliament, we will train thousands more GPs. We have already made an additional 250 training places available this year, taking the total to 4,250 places, with plans to expand that further. Let me turn to the specific points raised by the right hon. Member for Tatton, starting with Knutsford—as she said, we met about that last year. On the medical centre, East Cheshire trust is working on the outline business case, which it needs to submit to the ICB. The ICB needs to be satisfied with the submission, which would progress to a full business case, which would take some time to secure the necessary planning permissions. It also needs to look at how the clinical services work for both the general practice and the trust, and how they will be delivered, while ensuring that it is value for taxpayers’ money and lines up with the overall development that we want to see towards neighbourhood health services. As I have said to the right hon. Lady and many hon. Members, we expect ICBs to be collaborative and to keep their local MPs up to date and in the loop regarding plans for their constituencies. That is the situation at the moment: the trust is working on the outline business case with the medical centre, which is where that conversation needs to progress. On the main subject of the debate and the Carr-Hill formula, I must confess that I have seen this over many years in my time working as a manager in the NHS. It is a difficult issue, and one we are taking seriously, particularly when it comes to wider access in rural areas. Rural and remote areas face specific pressures, whether that is recruitment challenges, longer travel times or population fluctuations for various reasons, including tourism in some places. That is why the previous Labour Government introduced the formula in 2004, but we believe the formula is no longer fit for purpose today. A lot has happened in those 20 years and the research underpinning the formula was done in the 2000s, which means that so-called workload coefficients were estimated on the basis of data that may reflect clinical practice, such as patterns of home visits, from as far back as the early 1990s. Clinical practice and population health have changed markedly since that time. GP practices serving more deprived areas receive 9.8% less funding on average per needs-adjusted patient than those in less deprived communities. That is despite having greater health needs and significantly higher patient-to-GP ratios. We are asking experts to help us to design a formula that reflects patient need more accurately, working on the principle that funding for core services should be distributed equitably between patients across the country. Deprivation is a factor, but not the only one. Let me be clear, this is not about taking GPs away from urban areas or robbing Peter to pay Paul. It is about ensuring that funding is fairly distributed. The right hon. Lady rightly said that the review is being conducted by the National Institute for Health and Care Research. The review team has already engaged with partners at the Royal College of GPs, the general practice committee of the British Medical Association and the NHS Confederation, among others. Although I cannot pre-empt the review, the point is to ensure that funding is targeted towards areas that need it most. That means considering a broad range of factors relevant to the delivery of primary care services, including difficulties delivering services in rural areas, as she and others have outlined. We expect the first phase of that to conclude in March. We will then see whether there is a need for further work to technically develop and model any proposed changes to the formula. In response to the right hon. Lady’s question, we will of course look to understand the impact of any changes to the current formula on practices across the country ahead of implementation. The Minister for Care, my hon. Friend the Member for Aberafan Maesteg, will update the House on the progress and outcomes of the review in the normal way. Lastly, although many hon. Members will know this, it is worth highlighting that some 40% to 50% of GP practice funding is currently not determined by this formula. The income into GP practices is based on a number of other areas as well. We will obviously develop our neighbourhood health services in future, so we need to take notice of all those factors. I want to comment on the point that the right hon. Lady raised about analogue and digital. That is a key part of our 10-year plan. As the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), said last week, wherever people live in our country, they deserve the same access to healthcare as everyone else. Wealth should not determine health, nor should a postcode. I understand the point that the right hon. Lady and others have made—it has been made to me very often—about infrastructure and access, particularly digital. However, using digital based on geography offers huge potential to fight inequalities. For example, because of the online services for GPs that we launched in October, patients can now contact GPs through online services to request an appointment or raise a non-urgent query, which is in addition to telephone and in-person requests. That is tackling the 8 am scramble that we committed to addressing when we came into power, so that patients no longer have to wait by their phone to call GPs at a time of day when many go to work or get their kids ready for school. The right hon. Lady correctly says that rural communities largely have older populations. We want to be digital by default—and many older people are very digital—but human where it matters. That means that people in rural areas and elsewhere will still be able to use the phone if they want to, and they will not be waiting nearly as long because the other phone lines are being freed up. We are seeing real progress in that area. When we came into government, the front door of the NHS was hanging off its hinges. In these 18 short months, we are seeing the green shoots of recovery in general practice and recovery and reform in primary care. Our plan for change is creating a neighbourhood health service that puts GPs at its heart, so that the NHS is there for everyone, wherever they need it. We know that is not going to be easy and we want to work with it to develop that. I hope that today we have set out how we are trying to get there. Yes, there is more investment, but there is also fundamental reform, and my hon. Friend the Member for Aberafan Maesteg will be happy to keep in contact with Members as we progress this issue. Question put and agreed to.

• 28 Jan 2026 · Health Inequalities: Women · Hansard source

  More

  The hon. Member and I discussed this issue before he brought a debate on it to Westminster Hall, and I know that he has campaigned hard on it for local women. He raises an excellent point: we must ensure that what is happening on the ground with regard to maternity and the changes that people are proposing line up adequately with the national task. He has made that point very clearly today, and I will make sure that the local system is aware of it.

• 28 Jan 2026 · Health Inequalities: Women · Hansard source

  More

  The hon. Lady raises a shocking example. I think I have said this at the Dispatch Box before, but it is one of the most shocking experiences, on coming in as a new Minister, to see the scale and depth of sexual harassment of staff and other women. We have worked hard with staff groups to make sure that that is given primacy in our strategy. I am working with the Minister with responsibility for violence against women and girls—the Under-Secretary of State for the Home Department, my hon. Friend the Member for Birmingham Yardley (Jess Phillips)—and this is part of our attack more generally on misogyny and violence against women. We absolutely recognise that it needs to be resolved.

• 28 Jan 2026 · Health Inequalities: Women · Hansard source

  More

  We are committed through our 10-year health plan to prioritising women’s health as we build an NHS that is fit for the future. That includes renewing the women’s health strategy, investing in research that addresses health inequalities and continuing to build on vital progress in women’s health.

• 28 Jan 2026 · Health Inequalities: Women · Hansard source

  More

  It was the cases of many women like Debra, which have often been raised in this House, that led to that report, and we understand that people are facing serious and long-lasting conditions. I am happy to arrange for a Minister to get back to the hon. Member on that specific case and update him on the review.

• 28 Jan 2026 · Health Inequalities: Women · Hansard source

  More

  As we have discussed in this House and with the many people who have led the campaign on this issue, of course we are clear about the impact on those women. The Government will continue to review the recommendations of that report and will report back in due course.

• 28 Jan 2026 · Health Inequalities: Women · Hansard source

  More

  I thank my hon. Friend for the work that she has done, alongside many others, on behalf of black and Asian women in particular to make sure that that work is included in Baroness Amos’s report. That is central to the work that she will do. We know that there are high risks. There are engagement groups as part of that work, and I will make sure that my hon. Friend and others are kept up to date on that.

• 28 Jan 2026 · Health Inequalities: Women · Hansard source

  More

  My hon. Friend raises the great work going on in that local system. The work to renew the women’s health strategy is partly about finding those good examples. We rightly talk about how the experiences of women are often poor examples of healthcare—we know that—but we also want good examples of where local systems are leading that work. We certainly want to learn from what they are doing to inform the wider strategy, and part of renewing that strategy is making sure that it is effective.

• 28 Jan 2026 · Long-term Health Conditions: Women · Hansard source

  More

  The hon. Gentleman is absolutely right to say that osteoporosis disproportionately affects women and plays a crucial part in absence from the workforce. Baroness Merron, who leads on this work, and I met Charlie Mayfield when he was looking at how to get more women back into the workforce, and we will ensure that women’s health and these sorts of long-term conditions are part of that. I cannot commit to an MSK strategy, but we are absolutely committed to including this in our renewed women’s health strategy.

• 28 Jan 2026 · Long-term Health Conditions: Women · Hansard source

  More

  Through the big shifts in our 10-year health plan, we will ensure that more tests and care are delivered in the community, improving working between services, using greater use of technology to support women who are managing long-term conditions and, crucially, learning from the work led by the pioneering women’s health hubs.

• 27 Jan 2026 · Medical Training (Prioritisation) Bill · Hansard source

  More

  I beg to move, That the Bill be now read a Third time. I will not use this time to rehearse any of the arguments made today. We have had some good discussions. I want to thank the Leader of the House, the Chief Whip, parliamentary counsel and business managers, the public servants in my Department and NHS England, who have worked so hard to bring this together, and the devolved Governments for their support. They really have worked well together to bring this important measure to this place. I am also grateful to all colleagues for scrutinising the Bill so thoughtfully and thoroughly during today’s proceedings and, as I said previously, for meeting me last week to go through some of the provisions. It shows that Parliament can put its shoulder to the wheel and get stuff done in the public interest. We act in the public interest because we were elected on a mandate to fix our broken NHS and make it fit for the future, and we will not succeed in that goal without our workforce, who are and will always be our greatest asset. When I worked in the NHS during the Lansley reforms, I had a front-row seat to see their devastating impact on staff morale. I saw that patients bore the brunt of some of that collapsing morale. When our workforce does well, our NHS does well. That is why we are working to restore confidence and renew belief among frontline staff. The Bill is another step on that journey, and I urge colleagues to come with us and see it through. Question put and agreed to. Bill accordingly read the Third time and passed.

• 27 Jan 2026 · Medical Training (Prioritisation) Bill · Hansard source

  More

  In the interests of time, I will address the amendments at the end of proceedings, when I have heard from them—I think we have the gist of most of those issues. I restate our firm commitment to the Bill and all clauses. Let me turn to clause 4 and clarify how we are defining “UK medical graduate” and “the priority group” for the purposes of the Bill. “UK medical graduate” in this context excludes those who have spent all or the majority of their time training for their medical qualification outside the British isles. This means that if a person has obtained a primary UK qualification but has studied mainly overseas, they will not be eligible for prioritisation as a UK medical graduate unless they fall into another group that is to be prioritised under the Bill. While internationally educated graduates from overseas remain an important part of the workforce and can continue to be recruited under the Bill, we are committed to growing home-grown talent, who are more likely to work in the NHS for longer, and to be better equipped to deliver healthcare tailored to the UK’s population. Clause 8 sets out the territorial extent of the Bill and deals with commencement. The Bill extends to England, Wales, Scotland and Northern Ireland, and we have worked closely with the devolved Governments to ensure that it meets all needs and provides consistency. We are grateful to them for their support in bringing these measures forward so quickly. The Bill will engage the legislative consent motion process, and the devolved Governments have committed to commence this process in their Parliaments. To ensure that the systems, planning and operational capacity required for successful implementation are in place, the Bill will be commenced “on such day or days as the Secretary of State may by regulations appoint.” As the Secretary of State outlined on Second Reading, this is an important fail-safe to ensure that we are not in a position in which a law is enacted that we cannot implement effectively at the time. I am happy to expand on that after we have discussed the amendments, but the key issue is the ability of the NHS and training providers to deliver the measure. That is why we have a fail-safe; we first need to be very clear that the NHS is in a position to deliver. Members have talked about the strikes. Those would be one consideration, and there are many others. We are asking the NHS and training providers to do something very difficult very quickly, and in order to ensure that they have the capacity and capability to do it safely, we are reserving the right to commence the Bill at a later date, rather than at the end of this Session. I will come back to the amendments when I close the debate.

• 27 Jan 2026 · Medical Training (Prioritisation) Bill · Hansard source

  More

  I am coming to the hon. Gentleman’s point. We will keep the current system under review—I think the Secretary of State was clear about that—but we think that any change is best made through established guidance rather than through legislation. Many Members raised the issue of our relationship with Malta and Queen Mary, and the work that is done there. That relationship is clearly important. We have a great deal of work ongoing with Queen Mary, in the medical field as well as others. We are not excluding anyone. We are making sure that the prioritisation works in the best way possible, and we will of course keep all that under review. I thank hon. Members for their constructive debate on this important legislation. Question put and agreed to . Clause 1 accordingly ordered to stand part of the Bill. Clauses 2 and 3 ordered to stand part of the Bill. Clause 4 “UK medical graduate” and “the priority group” Amendment proposed: 9, page 3, line 3, after “are” insert “a British citizen or are”.— (Stuart Andrew.) This amendment would require British citizens to be prioritised for places on UK Foundation programmes and for interviews and places on speciality training programmes from 2027 onwards. Question put, That the amendment be made.

• 27 Jan 2026 · Medical Training (Prioritisation) Bill · Hansard source

  More

  I am grateful to Members for their contributions to the wider debate at this hour and for their considered amendments. I will respond briefly to their points and the amendments that have been tabled. Amendment 6 and 7 would widen the scope of who is prioritised for specialty training starting in 2026 by prioritising applicants who worked as a doctor in the health service on 13 January. Although we welcome the intention to recognise the importance of internationally trained doctors, we cannot accept the amendments at this time. They would mean that the Bill was ineffective in delivering on its intention to tackle bottlenecks and ensure that we have a sustainable medical workforce that can meet the needs of the population. I remind the Committee again that the Bill does not exclude anyone. In particular, there are likely to be opportunities in specialties such as general practice, core psychiatry and internal medicine, which historically attract fewer applicants from the groups we are prioritising for 2026. International medical graduates also continue to have opportunities in locally employed doctor roles. That could lead to NHS experience that might count towards future prioritisation as we look to make regulations to set criteria for what is considered “significant” NHS experience from 2027. Amendment 10 would ensure that members of the armed forces are not excluded from prioritisation due to having undertaken medical training while on posting outside the British islands. We cannot accept that amendment as we believe it is not necessary. That is because medical cadets do not spend time outside the British islands as part of their UK medical degree. While cadets undertake their elective with the military, which may be overseas, that is no different from other civilian medical students, many of whom undertake electives overseas. As such, we do not believe that medical cadets are disadvantaged by the Bill. Amendment 9 would include all British citizens within the priority groups so that British citizens will be prioritised for the purposes of the foundation programme and specialty training from 2027 onwards. It has no effect for 2026 specialty training, as British citizens are already prioritised by virtue of their immigration status. We therefore cannot accept the amendment. To do so would risk a significant increase in the pool of prioritised doctors who would compete with UK-trained doctors. The amendment would incentivise the expansion of the market for overseas medical schools, including medical schools working with foreign Governments to grow the overseas campus sector. That could offset any increase in postgraduate training places and undermine workforce planning. While British citizens will be prioritised for specialty training places in 2026, this is a proxy that is necessary for practical reasons. From 2027 we want to prioritise applications with experience and training based in the NHS. Again, prioritisation does not mean exclusion. International medical graduates who are not prioritised will still be able to apply and will be offered places if vacancies remain after prioritised applicants have received offers. However, it is important that we do not incentivise actions that will undermine the Bill. This Bill will reduce competition for places for UK-trained doctors so that home-grown talent can become the next generation of NHS doctors. Amendment 8 would limit the definition of a UK foundation programme in clause 5 to include programmes only where the majority of training has occurred within the UK. Although I understand the desire to do that, the number of doctors on a foundation programme within the meaning of the Medical Act 1983, but where the majority of training occurs outside the UK, is very small. Indeed, we understand that there is only one such active training programme. There are fewer than 25 doctors on that programme this year, of which fewer than five applied to continue their training in the UK. As such, there is no material impact on the Bill, so we do not think amendment 8 is necessary. However, we will keep the situation under review. Amendments 2, 3, 4 and 5 would change the procedure for making regulations to set additional priority groups for specialty training from 2027. The regulations would prioritise additional groups based on criteria indicating that a person is likely to have significant experience of working as a doctor in the health service or by reference to their immigration status. To be clear on our intention, the Bill sets out the groups of people who are to be prioritised for specialty training from 2027 onwards. The delegated power is limited to adding to that list by reference to their having “significant experience of working as a doctor in the National Health Service”, or immigration status. Although I am sympathetic to the desire for more parliamentary scrutiny, as outlined by the hon. Member for North Shropshire (Helen Morgan), we believe that, due to the limited scope of the power, the negative procedure is justifiable. I therefore encourage her not to press those amendments to a Division. Amendment 1 would change the commencement of the Bill—from being commenced by regulations to being commenced automatically on Royal Assent. As my right hon. Friend the Secretary of State outlined, the commencement clause is important, and I have addressed that point. It is a failsafe that, given the tight timeline for introducing the Bill, will ensure that we are not in a position where a law is enacted that we cannot implement effectively for whatever unforeseen reason. As I have said, there is also the question of whether it is even possible to implement prioritisation if, for example, the strikes are ongoing, given the strain that they put on resources and the impact that could have on delivery of the Bill. Because our objective is not just to move quickly but to get this right, these considerations are key to the commencement of the Bill, which is why the Government believe that we need to be able to commence the Bill when it makes sense to do so. For those reasons, we cannot accept the amendment. We do not think that new clauses 1 and 3 are necessary, because the data is already published, or, as we have said, we would be seeking to monitor the impact. New clause 2 would require the allocation of individual candidates to foundation and specialty training places on merit, once the requirements to prioritise certain applicants had been met. We consider the new clause to be unnecessary at this time because existing systems for recruitment to foundation and specialty training already assess the applicants on many of the merits outlined by in it. The Bill does not alter that; it simply ensures that UK medical graduates and other eligible applicants are prioritised.

• 27 Jan 2026 · Medical Training (Prioritisation) Bill · Hansard source

  More

  I am going to make some progress. Time is of the essence, I am afraid, but we can pick up more in Committee. When I was a manager in the NHS, I worked alongside many overseas doctors, and I want to make it clear from this Dispatch Box this afternoon that they are, of course, welcome here. The NHS is and always will be one of the most diverse employers in the world. This Bill is about bringing future generations into the health service and giving them the secure future that we all know they need. It is about sustainable workforce planning so that patients are no longer at the mercy of the market. Crucially, it is also about fairness. How is it fair that every year the taxpayer picks up a £4 billion bill to train medics who cannot then get jobs? Those taxpayers deserve a return on their investment. How is it fair that medics in this country put themselves forward to train, make sacrifices, get into debt and work long hours only to find themselves trapped in bottlenecks? I am going to try to address a number of colleagues’ points. I commend my hon. Friend the Member for Sunderland Central (Lewis Atkinson), for his experience and for outlining the capacity and demand issues that people like him have to face as managers, and also for his important point about our workforce needing to reflect our society. He talked about the great work being done in Sunderland, and I was pleased to meet the leaders there, including Dr Wilkes, to see the work they are doing so that we can take that elsewhere. That is exactly what we want to do. I also commend my hon. Friend the Member for Carlisle (Ms Minns)—the mum of a nurse, as she told us—for putting on the record the work of the Pears Cumbria School of Medicine and the intention of growing doctors who are steeped in Cumbria. She also mentioned health inequalities, and I would be pleased to meet my hon. Friend to discuss those issues further. My hon. Friend the Member for Thurrock (Jen Craft) was right to highlight the soaring numbers of people we are losing and to recognise that it was all going back to front. Why do we need emergency legislation? We need Royal Assent by 5 March at the latest to ensure that the change happens this year. We do not want medics to face another year of bottlenecks. Specialty training offers will be made from March, and any delay will risk vacancies in August. This emergency legislation gives the NHS the certainty and stability it needs to carry on bringing down waiting lists and to keep us on the road to recovery. The people applying for those posts need enough time to make decisions about their lives, including deciding where they will move, finding accommodation and sorting childcare, and they deserve enough time to get on with that. A number of colleagues have raised the definition of prioritisation for training posts. Let us be clear that, for specialty training posts starting this year, we will prioritise UK medical graduates and others, using their immigration status as a proxy for having significant experience of working in the health service. Colleagues might wonder whether there has been some pulling of strings to include Irish doctors in that prioritisation, but I can assure them that that is not the case. Ireland is included because of our special and long-standing relationship with Ireland and very similar epidemiology. I thank the hon. Member for South Antrim (Robin Swann) for the important points he raised about Magee College and working with the devolved institutions. I can assure him that officials have worked closely with officials in Northern Ireland on this. If there are any other issues, he should please raise them, but we have worked closely on that point. From next year, 2027, immigration status will no longer automatically determine priority. I accept some of the points from my hon. Friend the Member for Poole (Neil Duncan-Jordan) . He perhaps suggested that the proposal was crude, but it is a proxy for this year. Next year we will bring forward regulations to prioritise whether someone has significant experience as a doctor in the health service or by reference to their immigration status. This point was raised by the Chair of the Select Committee, the hon. Member for Oxford West and Abingdon, and many others. We will continue to work with all partners and the devolved Governments to agree those criteria in time for the autumn application round. On international staff, my hon. Friends the Members for Birmingham Edgbaston (Preet Kaur Gill) and for Uxbridge and South Ruislip (Danny Beales), the Chair of the Select Committee and others raised the issue of foreign doctors. Let us be clear that international staff play an important role in our NHS and they always will. The NHS might be the most diverse public body in the world, and we would not have it any other way, but we are recruiting doctors from abroad—sometimes even from countries that are short of medical staff—when there is already a pool of applicants at home. As my hon. Friend the Member for Morecambe and Lunesdale (Lizzi Collinge) said, we are not about nicking other people’s workforces. Home-grown doctors are more likely to work in the NHS for longer, and be better equipped to deliver healthcare tailored to the UK’s population, because having been trained in the UK’s epidemiology, they better understand it. It is not fair for British taxpayers to spend over £4 billion training medics every year, as my hon. Friends the Members for Worthing West (Dr Cooper) and for Cannock Chase (Josh Newbury) said. Nor is it fair for doctors who struggled to get into specialty training places. As my hon. Friend the Member for Birmingham Edgbaston said, a responsible Government get a grip on this. I will refer to the amendments when we move into Committee of the whole House. We are seeing the green shoots of recovery as we repair the NHS following the damage done over the past 14 years. We are turning another page on that decline. However, the decision in 2020 to lift visa restrictions has done untold damage to the system and to staff morale, and contributed to a national mood of cynicism and pessimism, especially among the young, so we need to act. Those points were articulated well by the hon. Member for Weald of Kent (Katie Lam), and expertly, as always, by my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley). Let me end my remarks by talking about the many young people who will be affected by the changes that we are setting out. As my hon. Friend the Member for Ipswich (Jack Abbott) said, these are not abstract statistics but personal costs. When I speak to those in my family, my constituency and even my parliamentary office who have breached the first barrier of getting to a medical school from a state school, I am disheartened to hear how many of them feel that their careers would be better served by moving abroad. In the 1970s, James Callaghan said that if he were a young man, he would emigrate. I do not want young people to take that path; I would rather say to them, “By all means, travel, see the world and enjoy that time, but there are great opportunities for you all in this country, and we want you to rebuild the NHS with us.” My niece is currently in Australia, and we sometimes call this the “bring Talia home Bill”. The NHS must play its part in training our young people and keeping top talent in the UK. If colleagues agree that that is worth doing, and if they want to keep our people here, they should join us in voting for the Bill. Question put and agreed to. Bill accordingly read a Second time ; to stand committed to a Committee of the whole House (Order, this day).

• 27 Jan 2026 · Medical Training (Prioritisation) Bill · Hansard source

  More

  It is a pleasure to close on behalf of the Government. I welcome the support of the Opposition spokespeople and the Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran). I put on record my thanks to them for meeting me in advance of the Bill and for airing their concerns. From the many contributions this afternoon, there is clearly a broad base of sympathy and support right across the House for the measures in the Bill to support our NHS staff, who have been at the sharp end of every ill-conceived policy of the past 14 years—not least since the previous Government lifted the visa restrictions in 2020, as outlined by my hon. Friend the Member for Bournemouth West (Jessica Toale). The last Government’s failure to do any proper workforce planning has also led to patients struggling to find a GP appointment while GPs struggle to get a job, bottlenecks for resident doctors and an over-reliance on overseas workers and a refusal to foster our own home-grown talent. Although I welcome the support, I find it slightly ironic that some of the Opposition speeches were around the need for clear and consistent routes and for clarity. That is exactly what we intend to provide to fix the mess. We will bring forward wider issues in the workforce plan, which, as the boss said earlier, will be in the spring. That is as a result of the concerns around training from the Royal Colleges and other stakeholders and making sure that we do that properly. We will bring that forward in due course.

• 26 Jan 2026 · NHS Urgent Care: Staffordshire · Hansard source

  More

  When I became a Minister, my hon. Friend was one of the first through the door to share some of the issues in Stoke. In my meeting today, in which I had my map in front of me to point out some of the journey times, his comments were in my mind. As I said, it is really important that we take local people with us as we move the system on the basis of the best clinical evidence. For me, that includes making sure that MPs are well informed of the proposals and the rationale behind them. As we have heard today, MPs are willing to be very constructive advocates for local systems on behalf of their constituents. I welcome the engagement with Members on this issue, and I am very happy to continue working with my hon. Friend the Member for Cannock Chase, other colleagues in Staffordshire and NHS leaders on how we can further strengthen emergency care services for people in Cannock Chase and, indeed, across Staffordshire. Question put and agreed to.

• 26 Jan 2026 · NHS Urgent Care: Staffordshire · Hansard source

  More

  It is a pleasure to respond to this debate, and I am grateful to my hon. Friend the Member for Cannock Chase (Josh Newbury) for securing it and raising in a constructive way the important matter of urgent care in Staffordshire. It is always good to have more proud NHS non-clinical bureaucrats in this place to pursue these issues. This Government are clear that the patient should expect, as my hon. Friend says, high standards of care. We recognise that that has not always been the case in recent years, with too many people waiting too long to access the help they need, but we are determined to change that. We are taking serious, sustained action to restore timely access to high-quality urgent care across the country. Our urgent and emergency care plan for 2025-26 sets out that clear path to strengthening urgent care outside hospitals, so that patients can access timely, appropriate support without needing to attend A&E unless clinically necessary. We are increasing the number of patients treated closer to home by scaling up our urgent community response teams providing rapid two-hour care, expanding virtual wards to provide hospital-level treatment at home and growing multidisciplinary neighbourhood teams that intervene early and prevent avoidable deterioration. We will support patients to book into the most appropriate urgent care service for them, whether via 111 or the NHS app, and we are using data from shared patient care records and digital tools to support better triage, to join up services and to anticipate pressures before they arise. That is backed by £2 billion of investment in NHS digital infrastructure. We are also investing £250 million to strengthen same-day emergency care and urgent treatment centre provision, helping systems across the country to avoid unnecessary admissions and supporting the same-day diagnosis, treatment and discharge of patients. Turning specifically to my hon. Friend’s constituency, I know the work that he has done with his local NHS to ensure that his constituents’ voices are heard. In preparing for this debate, I also met the local NHS to understand better the situation that he describes. It is taking steps to strengthen urgent care capacity and to improve patient pathways, in line with the policy outlines that we have made. I am also aware of the concerns about the closure of the minor injuries unit. As my hon. Friend said, following the closure during covid the ICB undertook a review of whether the service should be reopened. The review concluded that demand previously met by the Cannock Chase minor injuries unit was being met elsewhere. In that time, the NHS has strengthened the wider urgent care offer for local people. It includes enhanced primary care—my hon. Friend talked about wound care, which is very important to local people—as well as GP out-of-hours services accessed via NHS 111, urgent community response services, and access to urgent treatment centres in other locations. Those arrangements ensure that patients can receive timely and appropriate care. As my hon. Friend mentioned, neighbourhood integrated teams will be scaled up, delivering more proactive and preventive care in order to intervene earlier and reduce avoidable deterioration. Those teams, as he outlined, are central to shifting care out of hospital and towards community care support. Urgent treatment centres do play a vital role in the wider urgent care system, providing timely assessment and treatment for patients whose needs are urgent but not life-threatening. The system is therefore ensuring that those centres meet national standards, improving consistency and simplifying access for the public, to help divert activity away from type 1 emergency departments and ensure that more patients receive the right level of care closer to home. Let me say in response to my hon. Friend and also his neighbour, my hon. Friend the Member for Stoke-on-Trent Central (Gareth Snell), that it is important for Members in the area to understand that that wider movement of capacity will ensure that they have the necessary information. I am pleased to report that the system in Staffordshire has become the first in the midlands to establish a 24/7 integrated care co-ordination centre, which provides a single access point for clinicians, co-ordinates urgent community services, and prevents unnecessary A&E attendances. Nearly half the calls to the service are now successfully redirected away from hospital, which helps patients to access help more quickly and eases the pressure on A&E departments. Moreover, capacity has been increased in urgent community response services, virtual wards, same day-emergency care and intermediate care. Urgent community response performance is particularly strong, with more than 78% of referrals seen within two hours—well above the national ambition of 70%. Additional clinical resource has been put in place to meet rising demand and support resilience through the winter. This work sits alongside strengthened pathways for people whom my hon. Friend described—especially those who may be elderly and experience falls, those who may be frail, those who need end-of-life care, and those in care homes. We need to ensure that those patients in particular receive timely and appropriate support and are confident that the service is there for them in that time of need. Together, these integrated services are helping to manage demand in A&E departments, improve patient flow, and make best use of urgent care capacity across Staffordshire, including in Cannock Chase. As my hon. Friend rightly said, those improvements must be felt by the people of Cannock Chase, and as my hon. Friend the Member for Stoke-on-Trent Central also pointed out, we need to ensure that demand is well managed and to support people across Staffordshire. We are planning for the future as well. Our 10-year health plan sets out the long-term vision for urgent and emergency care reform. As I have said, a central priority is to shift care from hospitals into the community, and that will be driven by continuing to expand urgent care through urgent community response, virtual wards, rapid access clinics and better co-ordination through neighbourhood-based care. Our plan is working: in the past 18 months the Government have invested a record £26 billion in the NHS, delivered more than 5 million additional appointments, cut waiting lists by 312,000, and launched the 10-year health plan to deliver more care in the community. We know that there is more to do, but our investment and modernisation are making a difference, and the NHS is showing clear signs of recovery. Thanks to these steps, this winter ambulances are arriving faster, A&E waits are shorter, and more patients are being treated closer to home. I pay tribute to NHS staff across Staffordshire and across the country. Doctors, nurses, paramedics, healthcare assistants and support staff continue to show exceptional commitment, often in the most challenging circumstances, and they deserve our thanks and support. We know that the NHS is under pressure, but this Government are taking decisive action through our urgent and emergency care plan, our winter preparations, and our long-term reforms. We are putting the service back on its feet, and ensuring that patients receive timely, high-quality care. As we make the NHS fit for the future by making the changes we need to move care out of hospital and into communities, and by making the switch from analogue to digital and from sickness to prevention, we have to communicate better with patients and the public, as my hon. Friend the Member for Cannock Chase has clearly outlined this evening. That includes keeping MPs well informed of the proposals.

• 20 Jan 2026 · Domestic Abuse-related Deaths: NHS Prevention · Hansard source

  More

  It is a pleasure to serve under your chairship this morning, Sir John. I thank my hon. Friend the Member for Stroud (Dr Opher) for securing the debate and, as others have said, for sharing his direct experience as a practitioner—he is still a jobbing GP, among his other roles. His expertise was apparent throughout his speech. As a Member of Parliament I have long talked about this issue, which is massive for me personally and as a constituency MP. All colleagues will be aware, through our casework, of how widespread domestic abuse is. It is one of the biggest issues for me in Bristol South. The number of women who fear injury or worse at the hands of their partners should keep us all up at night. The Office for National Statistics estimates that well over 2 million women have experienced domestic abuse in England and Wales in the last year alone. Year on year, domestic homicides are present in all our constituencies. There were 108 domestic homicides in the year ending March 2024. Getting the right support early could help to prevent these needless and tragic deaths. My hon. Friend the Member for Stroud asked the Government to publish a comprehensive plan for health. We now have a clear agenda for officials, as set out in the commitments in the violence against women and girls strategy. I will personally ensure that we make progress on that throughout 2026. My hon. Friend asked for the Department’s contribution to the VAWG strategy to be increased in future budgets. I am happy to confirm that we are doing that over this spending review period. As well as the £5 million annual investment for victim and survivor support services, we are committing up to £50 million over the next three years to the roll-out of the child house model. In addition, the Department will provide dedicated funding for the Steps to Safety referral service for those affected by domestic abuse. I will address both those points later in my speech. My hon. Friend was also right to emphasise the importance of specialised NHS training on domestic abuse, which I will also pick up later. Tackling domestic abuse has to become everyone’s business, as we have heard today, so the whole of Government are behind the agenda to prevent abuse and save lives. We saw before Christmas—if people had not recognised it before—the Prime Minister’s personal commitment to this agenda. I spoke plainly from the Opposition Benches about how the cost of living crisis was impacting women, and I will not now sugarcoat that fact from my Government position. Many women face the impossible choice of staying in an abusive situation or destitution. My right hon. Friend the Work and Pensions Secretary is doing everything he can to support people back to work more generally, and particularly to help women to gain financial independence and keep them free of coercion. While this work is all necessary, it is not sufficient. NHS staff will play a vital role in helping victims and survivors to access health, housing and justice. As we have heard, healthcare workers are often the first point of contact, offering support, treatment and rehabilitation. They have their eyes on those at risk. My hon. Friend the Member for Stroud made an excellent point about fragmented services, and I take the point made by the Opposition spokesperson, the hon. Member for Farnham and Bordon (Gregory Stafford), that with recognition comes responsibility for delivery. We absolutely recognise that. The support we offer must be consistent, responsive and easier to reach. As the Liberal Democrat spokesperson, the hon. Member for Epsom and Ewell (Helen Maguire), said, the incidents we have heard about from colleagues this morning are not isolated; this is a systemic issue. As my hon. Friend the Member for Bolton North East (Kirith Entwistle) said in her excellent speech, we need to join the dots. Like all our public servants—teachers, social workers and the police—NHS workers already play an essential role in safeguarding. As my hon. Friend the Member for Leeds Central and Headingley (Alex Sobel) said, that includes dealing with so-called honour-based killings. For instance, partners are often asked to leave the room before a midwife asks a mother whether she feels confident that no one will try to hurt her or her baby. We take our duty of care towards survivors of abuse extremely seriously, because violence against women and girls is, as we have heard, a public health emergency. GP surgery staff are at the frontline of our commitment to safeguard lives. Since we came into office, we have supported primary carers and GPs as the front door to the NHS, and we have recruited over 2,500 more GPs. We have since seen patient satisfaction improving, with the recognition that access is improving, and online consultations are ending the morning scramble for appointments, thereby supporting that frontline. This year, we will work with all ICBs to help staff in GP surgeries to identify and support victims and survivors of domestic abuse and refer them into wider support services. As we have heard, the Steps to Safety strategy will, first, introduce training for all staff in GP surgeries, to help them to spot the telltale signs of abuse and give them the skills and confidence to offer support to affected people. Secondly, a specialist worker will advise GP practices on supporting victims and survivors to take their first steps to safety by linking them with local support services. Thirdly, we will learn from the excellent practice that is already happening locally—for example, in places like Devon, Cornwall, Birmingham and Solihull. Support services could help women to escape their abusers and get back on their feet, whether by helping them to find housing, to get back into work or to put the perpetrators behind bars. We are rolling out this initiative from April, starting with 10 ICBs in the first year, and by 2029 any victim or survivor in England will be able to get the help they need by talking to staff at their general practice. We are determined to ensure that services do not become a postcode lottery. It is a shameful truth that some of the most alarming health inequalities are those faced by victims and survivors of domestic abuse and sexual violence. That is why my right hon. Friend the Secretary of State has asked my hon. Friend the Member for Lowestoft (Jess Asato), who made an excellent contribution to the debate, to advise the Government. She will look at how we reduce the impact of alcohol on violence against women and girls, how we commission services to ensure that the right support is in the right place, and how we embed support into neighbourhood health services so that women and girls can be connected to the specialist support they need. A lot of colleagues talked about training, including the hon. Member for Richmond Park (Sarah Olney) and my hon. Friend the Member for Stourbridge (Cat Eccles). We need to remember that health professionals are trained to identify and respond to all types of violence and abuse, using blended learning methods including e-learning, in-person training and supervision. National mandatory safeguarding training is being strengthened for launch in late 2026. We recognise that that needs to be done. The training will reinforce to staff their safeguarding responsibilities and support them in identifying and responding to victims of abuse. It will include training on the importance of recognising the impact of trauma and the cultural barriers to discussing abuse. It is the responsibility of employers to ensure that staff complete the mandatory safeguarding training. The Care Quality Commission assesses compliance with that requirement. The NHS England safeguarding team oversees this work, and has audited integrated care boards on completion rates. We will strengthen that work. It takes immense bravery for survivors, not least the survivors of child sexual abuse, to come forward and tell their story, and we are doing everything possible to end the trauma of children and young people having to relive their ordeal over and over, by bringing a range of specialist support services under one roof in every NHS region in England. This is called the child house model. We have started to recruit the extra mental health workers we want by the end of this Parliament, to help survivors who still carry the scars of their abuse, and we are more than halfway towards our target. Whenever and wherever a victim or survivor contacts the NHS, it must be there for them with compassion, care and dignity. The changes we are making to NHS England are to resolve many of the problems outlined by the Opposition spokesperson. We have huge problems with pathways as a result of layer upon layer of provision and bureaucracy have been introduced to the system over the last decade. There are confusing pathways, confusing levels of accountability, and massively increased costs with no improvement to the services received at the frontline. We need to support local delivery, where people present, and that is our intent with the changes. I was not aware that the Opposition were against the abolition of NHS England, but we will obviously make sure that we focus on service delivery as we go through the changes. Our starting point is that women and girls who are victims of abuse are never responsible for the abuse. The perpetrators are responsible for it, but tackling it is everyone’s problem. That is why my right hon. Friend the Home Secretary has started to deploy domestic abuse experts in 999 control rooms, building on best practice across the country, including in my own Avon and Somerset police area. It is why my right hon. Friend the Justice Secretary has introduced new measures to protect victims of stalking, and why my right hon. Friend the Education Secretary is taking steps to challenge misogyny in the classroom. The hon. Member for Strangford (Jim Shannon) highlighted the really shocking levels of killings, as well as abuse, in Northern Ireland. It is good to have that voice in this place. As he knows, I take a great interest in Northern Ireland, but we do not often hear about that particular situation there. I assure him that the Home Office, as the lead Department, has been working with all devolved partners to produce the strategy, and the Department of Health and Social Care is sharing learning, but we absolutely need to keep an eye on that to ensure that we support colleagues in Northern Ireland on this agenda. We are working across Government, which is why I am determined that the NHS will do its part in halving violence against women and girls by the end of the decade. However, our strategy is not just a Government plan; it is a national endeavour. Everyone in this room or watching on screen has their part to play. I want to end by speaking directly to survivors and anyone who may be trapped in an abusive relationship. This Government are on your side—and we have heard this morning a willingness across all parties to make this work. We have not forgotten you. You can get in touch with the Refuge national domestic abuse helpline, Women’s Aid or Respect—an organisation that works with male victims and perpetrators of abuse. Please get in touch with those or other specialist charities, or contact your local sexual assault referral centre. The Government are determined to make the strategy work and I am really grateful to have had the opportunity to respond to the debate.

• 13 Jan 2026 · Topical Questions · Hansard source

  More

  I thank my hon. Friend for her constructive approach to this difficult issue. She is right to challenge; we must have open and transparent debate. To be very clear—and to refer to my previous answer—the Secretary of State will use that power. We will have a retrospective data linkage study to identify the associations informing patient experience and outcomes, through the analysis of available digital information in health records and other nationally held databases. It will not establish causation but will be an important contribution to the evidence base.